G9513 Indiv pdc not > 0.8
Also known as: poor medication adherence, low compliance
Documentation that patient's individual Proportion of Days Covered (PDC) for medication adherence is not greater than 0.8 (80 percent or lower).
In Plain Language
patient not taking medicine regularly
Clinical Context
Medication adherence quality measure identifying patients with suboptimal adherence to chronic medications requiring intervention.
RVU Information
CPT G9513 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
G-codes are CMS-specific HCPCS codes for services not covered by standard CPT. Documentation requirements follow the same standards as the equivalent CPT service. Check Medicare LCD/NCD policies for coverage criteria.
How This Code Compares
This code has a work RVU of 0.00, meaning it does not have a physician work component assigned by CMS. In the G Codes category, 85% of codes share this characteristic.
Specialties
Frequently Asked Questions
What is CPT code G9513?
CPT G9513 (Indiv pdc not > 0.8) is a G Codes code. Documentation that patient's individual Proportion of Days Covered (PDC) for medication adherence is not greater than 0.8 (80 percent or lower).
Who uses CPT code G9513?
CPT G9513 is used by Primary Care, Pharmacy, Chronic Disease Management. Medication adherence quality measure identifying patients with suboptimal adherence to chronic medications requiring intervention.
When is CPT G9513 used?
Medication adherence quality measure identifying patients with suboptimal adherence to chronic medications requiring intervention.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against national data — all in one app.
CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.